Kawasaki병의 임상적 고찰 = The Clinical Observation in Kawasaki disease

다국어 초록 (Multilingual Abstract)

-Abstract- Purpose : This study was designed for clinical manifestations, laboratory findings, onset of coronary artery lesion and disease process after the high dose IVGG therapy in Kawasaki disease.
Methods : Fourty-four cases with Kawasaki disease who were diagnosed and treated at the Department of Pediatrics, Kosin University Hospital from January 1993 to April 1996, were investigated for their clinical manifestations and laboratory findings, and cardiac complications.
Results : (1) In age distribution, the most prevalent age group was under the age of 4 (81.9%) and the mean age was 2.7 ± 1.8 years old.
(2) Boys were more prevalent than girls, as a ratio of 2.1 : 1.
(3) Principal clinical features were high fever developed in 100% and lasted for 6.9 ± 3.8 days, polymorphous exanthem in 84.1%, conjunctival injection in 93.2%, oral cavity lesion in 90.9%, cervical lymphadenopathy in 59%, indurative edema of hands and feet in 63.6%, desquamation in 59%.
(4) Main laboratory findings were anemia 22.7%, leukocytosis 93.2%, thrombocytosis 81.8%, increased ESR 93.2%, positive CRP 100%, increased SGOT 19%, increased SGPT 30.9%, pyuria 57.8%, proteinuria 7.9%, microscopic hematuria 7.9% and abnormalities of EKG 18.1%.
(5) Abnormal findings of the heart were found in 40.9% by echocardiogram, the abnormality of coronary artery were present in 15.9% (which were coronary artery aneurysm 9.1% and coronary artery dilatation 6.8%), pericardial effusion 11.3% and moderate degree of mitral and tricuspid regurgitation 13.6%.
(6) 3 cases of coronary artery aneurysm were occurred in the IVGG 400mg/kg/day for 5 days group, 1 case of coronary artery aneurysm and 3 cases of coronary artery dilatation were found in the IVGG 1g/kg/day for 2 days group.
(7) The follow-up echocardiogram, 2 months later of IVGG administration, the result were as follows: ① Among 2 cases of mild coronary artery aneurysm, one was disappeared and the other was not followed.
② 2 cases of giant coronary artery aneurysm were not improved.
③ All cases of coronary artery dilatation and pericardial effusion were disappeared.
④ Among 6 cases of moderate degree mitral and tricuspid regurgitation, 5 cases were improved and other 1 case was improved from grade 3/4 to grade 2/4.
Conclusions : We concluded that early combination therapy with high dose IVGG and aspirin is effective for prevention of coronary artery aneurysm development and for treatment of acute inflammation in Kawasaki disease.